Abstract

ObjectiveAlzheimer’s disease and related dementias (ADRD) affect more than five million Americans and their family caregivers. Caregiving creates challenges, may contribute to decreased caregiver health and is associated with $9.7 billion of caregiver health care costs. The purpose of this 12 month randomized clinical trial (RCT) was to examine if the Enhancing Physical Activity Intervention (EPAI), a moderate to vigorous physical activity (MVPA) treatment group, versus the Caregiver Skill Building Intervention (CSBI) control, would have greater: (1) MVPA adherence; and (2) physical function.MethodsCaregivers were randomly assigned to EPAI or CSBI (N=211). MVPA was assessed using a self-report measure; and physical function was objectively assessed using two measures. Intention-to-treat analyses used descriptive, categorical and generalized estimating equations (GEE), with an exchangeable working correlation matrix and a log link, to examine main effects and interactions in change of MVPA and physical function over time.ResultsAt 12 months, EPAI significantly increased MVPA (p=<0.001) and number of steps (p=< .01); maintained stable caregiving hours and use of formal services; while CSBI increased hours of caregiving (p=<0.001) and used more formal services (p=<0.02). Qualitative physical function data indicated that approximately 50% of caregivers had difficulties completing physical function tests.ConclusionThe EPAI had a stronger 12 month effect on caregiver MVPA and physical function, as well as maintaining stability of caregiving hours and formal service use; while CSBI increased caregiving hours and use of formal services. A study limitation included greater EPAI versus CSBI attrition. Future directions are proposed for dementia family caregiver physical activity research.

Highlights

  • Alzheimer’s disease and related dementias (ADRD) currently affect more than five million Americans

  • Future directions are proposed for dementia family caregiver physical activity research

  • Given the prevalence of ADRD, the need for family care, and the toll that caregiving takes on family members’ mental and physical health (2), this study addressed a major public health problem-increasing physical activity of sedentary caregivers

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Summary

Introduction

Alzheimer’s disease and related dementias (ADRD) currently affect more than five million Americans. Research notes that caring for a person with dementia poses numerous challenges due to continued advancement of the disease and eventually, may contribute to decreased caregiver health. The physical and emotional impact of dementia caregiving has been associated with $9.7 billion in health care costs in the United States [2]. Caregiving is a complex process that is affected by the care recipient’s dementia severity, caregiver’s perceptions of care-related challenges and responsibilities, and caregiver’s personality and available resources. These complex factors must be considered when addressing the health impact of caregiving responsibilities and developing interventions designed to protect caregiver health [2]

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